Individual provider Active NPI

Patricia S Miller, MD

  • Pediatrics Physician
  • Moon TWP, PA
National Provider Identifier
1063415933
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD026342E Issued in PA
Practice address
1600 Coraopolis Heights Rd
Ste E
Moon TWP, PA 15108-4316
Phone
(412) 262-2415
Fax
(412) 262-1537
NPI assigned
May 24, 2005
Last updated
Mar 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD026342E PA Primary

Addresses

Primary practice location

1600 Coraopolis Heights Rd
Ste E
Moon TWP, PA 15108-4316

Mailing address

11279 Perry Hwy
Ste 450
Wexford, PA 15090-9303
Phone (724) 933-1100

Other identifiers 1

IdentifierTypeStateIssuer
0009374670013MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD026342EPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childen's Community Care Pediatrics PastSince May 10, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1063415933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11279 PERRY HWY",
            "address_2": "STE 450",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909303",
            "telephone_number": "724-933-1100",
            "fax_number": "724-933-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CORAOPOLIS HEIGHTS RD",
            "address_2": "STE E",
            "city": "MOON TWP",
            "state": "PA",
            "postal_code": "151084316",
            "telephone_number": "412-262-2415",
            "fax_number": "412-262-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "PATRICIA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD026342E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009374670013",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moon TWP, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.